- Medical Criteria Needed to Qualify with Rheumatoid Arthritis
- Evidence Needed Related to Your Rheumatoid Arthritis Medications and Treatments
- Evidence Needed Related Your Quality of Life and Ability to Care for Yourself
- Steps You Can Take to Win Your Disability Claim
- Rheumatoid Arthritis: ‘I Was Disabled Before I Was Disabled’
- Poor Sleep Quality is Associated with Greater Disability in Rheumatoid Arthritis Patients
- Age-Related Arthritis versus Rheumatoid Arthritis
- What Is Rheumatoid Arthritis?
- Rheumatoid Arthritis—Risk Factors and Initial Symptoms
- Conditions and Complications Associated With Rheumatoid Arthritis
- Individual and Group Long-Term Disability Benefits and Rheumatoid Arthritis
- Call America’s Top-Rated Long-Term Disability Lawyers and Award-Winning Group ERISA Attorneys for a Free, Confidential Consultation
- I Have Rheumatoid Arthritis – Am I Entitled To Disability Benefits? Qualifying Through A Listing
- Social Security Disability Benefits for Arthritis
- Can I Get Disability for My Arthritis?
- Does My Arthritis Meet a Listing?
Medical Criteria Needed to Qualify with Rheumatoid Arthritis
Therefore, it’s essential that you work with your rheumatologist to gather this medical information.
Evidence Needed Related to Your Rheumatoid Arthritis Medications and Treatments
Many patients who have rheumatoid arthritis take medications, which may include analgesics, NSAIDs, steroids, and disease-modifying anti-rheumatic drugs (DMARDs), In some cases, some people may still require steroid injections or pain blocks.
Other treatments for RA include physical therapy, occupational therapy, and lifestyle modifications. Joint replacement surgery is sometimes necessary in certain cases.
It is critical that your physician documents the following:>
- Medications you take, and what their dosage is
- How often you need medication
- Side effects of your medication, if any
- Any physical or occupational therapy that you receive and how often it is required
- Any changes to your life as a result of your rheumatoid arthritis
Evidence Needed Related Your Quality of Life and Ability to Care for Yourself
The Blue Book indicates that people with Rheumatoid Arthritis may qualify for benefits if they experience constitutional symptoms along one of the following:
- Limitations of activities of daily living (ADLs): This may include, but is not limited to, performing household chores, personal hygiene, taking public transportation, or paying bills.
- Limitation in maintaining social functioning: This may include communicating appropriately with others, managing sustained relationships, and interacting independently with others.
- Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace: This may include finishing projects on time, keeping up a reasonable pace at work, and the ability to work with rheumatoid arthritis without excessive breaks.
If you have difficulty working due to RA symptoms like the ones above, you should make sure your doctor documents these symptoms.
Many people with Rheumatoid Arthritis may not qualify for SSDI benefits through the Blue Book listing. However, you still may be too ill to work.
You may be eligible for benefits through a medical vocational allowance.
Steps You Can Take to Win Your Disability Claim
Winning your disability claim for Rheumatoid Arthritis is dependent on your ability to provide sufficient medical evidence.
You will need to prove to the SSA that your rheumatoid arthritis is severe and disabling enough to keep you from earning a living.
The best thing that you can do for your case is to gather medical documentation. You may need to visit the records department at your hospital, as well as gather all of the medical documents from your doctor, physical therapist, and all others involved in your care.
It is beneficial to be as organized as possible when applying for Social Security disability benefits. Keep a list of all of your healthcare providers, as well as their telephone numbers, email addresses, and fax numbers.
When you visit your doctor, it is a good idea to present a written list of symptoms and side-effects that you are experiencing, so that you can discuss them together.
There are several ways that your rheumatologist can help, including:
- Ensuring that your full medical history is up to date
- Listing your past treatments and responses, as well as the plan for the future
- Documenting all of your medications and experienced side effects
- Carefully documenting your physical exam, including all limitations
- Recording any mental health issues that you are experiencing as a result of your RA.
Many individuals who are applying for Social Security disability decide to enlist the help of an experienced disability attorney or advocate Your chances for approval go up substantially when you are working with a disability expert.
Evaluations are always free, and lawyers are only paid if you win your claim.
Rheumatoid Arthritis: ‘I Was Disabled Before I Was Disabled’
An excess in functional disability can continue even after a RA diagnosis and treatment, Myasoedova said.
She noted that this could be due to the growing burden of chronic mental and physical pain, ongoing use of steroid medications and antidepressants, increasing expectations for relief from and management of RA symptoms that may or may not be met, and other internal and external personality, genetic, biologic, and lifestyle factors.
The implications of the study are clear: doctors and patients need to be more vigilant and proactive in the early stages or pre-stages of rheumatoid arthritis.
Rheumatoid arthritis is an auto-inflammatory disease that not only has an impact on the immune and musculoskeletal systems but is also a condition that significantly affects quality of life and well-being.
RA is one of the primary chronic ailments associated with a strong level of ongoing functional disability in the United States, so doctors and patients need to keep an eye out for potential signs and symptoms.
With many illnesses such as RA, early detection and treatment is key.
What can you do?
“Alerting your healthcare provider to difficulties in daily living can assure that patients receive the help they need,” said Myasoedova. A typical case of rheumatoid arthritis begins gradually, with slow development of signs and symptoms over a period of weeks to months.
Erosion of bone and destruction of cartilage occur more rapidly than other symptoms and may be seen within the first two years of the disease, continuing to worsen as time goes on if the disease is not treated effectively.
And while there is no one-size-fits-all diagnostic blood test for RA, the Arthritis Foundation has stated that certain antibodies specific to RA can be present early on, existing before the disease symptoms even start.
One challenge the doctors face is that rheumatoid arthritis can be difficult to diagnose in its early stages mostly because many early signs and symptoms mimic or overlap with those of a wide array of diseases.
The average time from onset to diagnosis is six to nine months. But now, with the new study showing that these symptoms may begin even earlier than once thought — perhaps years earlier — an earlier diagnosis could be on the horizon for many.
Potter hopes so.
“I wish that other patients would be diagnosed sooner so they stand a better chance of finding a drug that works for them instead of suffering without answers for so long,” she said.
Poor Sleep Quality is Associated with Greater Disability in Rheumatoid Arthritis Patients
CONTACT: Emilee McStay, 630-737-9700, ext. 9345, [email protected]
DARIEN, Ill. – A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine found that poor sleep quality correlated with higher levels of depressive symptoms, greater pain severity, increased fatigue, and greater functional disability in patients with Rheumatoid Arthritis (RA). The study suggests that addressing sleep problems via pharmacological or behavioral interventions may have a critical impact on the health and lives of patients with RA.
The study represents a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA. The sample had an average age of 58.5 years, and 76 percent were female. All patients had been diagnosed with RA for at least two years; on average, patients had RA for 14 years.
Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II, Medical Outcomes Study Short Form – 36, and the Health Assessment Questionnaire. The results provided input on their sleep quality, depression, fatigue, and functional disability and pain severity, respectively. Patients also provided sociodemographic information and their medical history.
Results show that sleep quality has an indirect effect on functional disability after controlling for age, gender and number of comorbities. According to the PSQI results, 61 percent of patients were poor sleepers and 33 percent reported having pain that disturbed their sleep three or more times per week.
“The primary finding of our study is that poor sleep quality is associated with greater functional disability among patients with RA and this relationship may be explained by pain severity and fatigue,” said lead author Dr. Faith S. Luyster, research assistant professor at the University of Pittsburgh School of Nursing in Pittsburgh, Pa. “These results highlight the importance of addressing sleep complaints among patients with RA. By treating sleep problems either pharmacologically or behaviorally, symptoms and activity limitations associated with RA may be reduced.”
The study’s finding that poorer sleep quality is associated with greater pain severity is consistent with recent evidence suggesting that sleep disruption may lower pain threshold and enhance pain in RA and otherwise healthy adults.
According to the National Institute of Health, RA is an inflammatory disease affecting about 1.3 million U.S. adults, and causes pain, swelling, stiffness, and loss of function in the joints. Disturbed sleep has been found to be a major concern among persons with RA.
Physical disability resulting from polyarticular joint disease in patients with RA may limit their ability to carry out daily activities such as dressing, walking, grooming, and writing – tasks that can be further restricted by fatigue, pain severity, and depression.
It is possible that functional disability may affect depression, pain severity and fatigue, which in turn may affect sleep quality. It is likely that the relationships are bidirectional to some extent.
“Not sleeping well at night can contribute to greater pain sensitivity and fatigue during the day which in turn can limit a patient’s ability to engage in activities of daily living and discretionary activities,” Luyster said.
Luyster noted that treating sleep disturbances in RA patients might have beneficial effects beyond improving sleep.
The study was supported by grants from the National Institute of Health.
The peer-reviewed Journal of Clinical Sleep Medicine is published bimonthly and is the official publication of the American Academy of Sleep Medicine, a professional membership society that is the leader in setting standards and promoting excellence in sleep medicine health care, education and research.
For a copy of the study, “Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis,” or to arrange an interview with an AASM spokesperson, please contact Public Relations Coordinator Emilee McStay at 630-737-9700, ext. 9345, or [email protected]
Our founding partner Frank N. Darras, has practiced disability law for more than three decades. His disability litigation firm has more than 100 years of combined litigation and claim experience. After all that time, DarrasLaw’s top-rated individual disability attorneys and award-winning group ERISA lawyers know what age-related degeneration means. It means your individual or group long-term disability insurance company and its doctors acknowledge your illness. Then they conclude you’re not entitled to individual or group long-term disability benefits because your not disabled enough.
DarrasLaw’s nationally respected individual disability attorneys and pre-eminent group ERISA lawyers often see wrongful denials with arthritis claimants. However, not all types of age-related arthritis claims are deniable. The following arthritic problems can also cause disability:
- Joint infections
- Traumatic injuries
- Genetic disorders
- Immune system responses
An illness or injury that prevents you from performing the important tasks of your occupation, such as rheumatoid arthritis, can qualify you for individual or group long-term disability benefits. Many claimants, however, are wrongfully denied individual or group long-term disability benefits for arthritic conditions. Individual or group long-term disability insurers may claim you didn’t catch a truly disabling illness or suffer a traumatic disabling injury.
Furthermore, you won’t qualify for individual or group long-term disability benefits unless you meet the definition of a qualifying injury or illness under the terms and conditions of your individual or group long-term disability insurance policy. Insurers typically define injury as any “accidental loss” or bodily harm that occurs independently of all other causes. They generally define an illness as a physical or mental disease that first manifested or occurred after the policy is in force.
America’s top-rated long-term disability lawyers and award-winning group ERISA attorneys at DarrasLaw can review the terms and limitations of your long-term disability policy for free. We will also conduct a free disability claim consultation to determine whether your individual or group ERISA insurer has wrongfully delayed, denied, or terminated your individual or group long-term disability benefits. To schedule your free disability insurance consultation, call DarrasLaw today at (800) 458-4577 or contact us online.
Age-Related Arthritis versus Rheumatoid Arthritis
Arthritis is a Latin phrase that means “inflammation of the joints.” According to the Arthritis Foundation, arthritis is actually a catchall term for various types of joint pain and disease. Arthritis most commonly refers to osteoarthritis, which occurs when the padding between your joints wears down with time, causing your bones to rub together. This is common with age, and can cause movement limitations and pain that is often disabling.
Most individual and group long-term disability insurance companies assume that all joint pain and swelling is osteoarthritis. They typically deny claimants’ individual or group long-term disability benefits because osteoarthritis is allegedly the result of age-related wear and tear that happens with time. The term “age-related” degeneration refers specifically to this type of arthritic condition. However, this is only one type of arthritis.
Joint pain, stiffness and swelling can result from a condition called rheumatoid arthritis. This is an illness, not an injury. Rheumatoid arthritis is an autoimmune disorder diagnosed when your immune system malfunctions and attacks the healthy cells surrounding your joints. This attack inflames the tissues around your joints, resulting in pain and swelling along with disability.
Rheumatoid arthritis occurs on both sides of the body. This can distinguish it from age-related arthritis. For example, a right-handed tennis player may develop arthritis in the right elbow after years of overuse. However, she may not develop the same pain in her left arm. Either can be totally disabling with proper documentation.
Overuse of the joint doesn’t factor into the analysis with an immune system attack like rheumatoid arthritis. Anyone can develop rheumatoid arthritis, even children. It also can attack other parts of the body, not just the joints.
What Is Rheumatoid Arthritis?
When you have rheumatoid arthritis, your immune system is specifically attacking something called the synovium, the lining that surrounds your joints. Rheumatoid arthritis gets worse with time because your synovium inflames and thickens as it tries to heal and protect itself from the attacks.
This thickening eventually destroys both the cartilage and bone within the joint as the tendons weaken. Your joints will eventually fall out of alignment. Your immune system mistakenly creates antibodies that identify synovium as a germ or foreign body and begins to attack it.
Any part of your body with synovium in it is susceptible to a rheumatoid arthritis attack. As a result, rheumatoid arthritis is much more than a joint disease. According to the Mayo Clinic, almost half of all rheumatoid arthritis patients also suffer from swelling and pain in the following areas:
- Nerve tissues
- Blood vessels
- Bone marrow
- Salivary glands
Rheumatoid Arthritis—Risk Factors and Initial Symptoms
Often, providing objective, compelling medical evidence and proof of rheumatoid arthritis is necessary to claim individual or group ERISA long-term disability benefits. Unfortunately, some carriers deny rheumatoid arthritis claims, intentionally miscategorizing the problem as normal age-related non-disabling degeneration.
Rheumatoid arthritis commonly occurs between the ages of 40 and 60, which is why it’s often mistaken for age-related osteoarthritis. However, the following factors can increase your risk of rheumatoid arthritis:
- Smoking – Smokers, especially those genetically predisposed to rheumatoid arthritis, are at a higher risk of developing it. Smoking also increases the severity of the condition.
- Environmental factors – Exposure to asbestos or other germs can result in an increased risk of developing rheumatoid arthritis. Emergency and disaster relief workers are known to have developed this condition disproportionally to the rest of the population. Workers’ compensation insurance may cover on-the-job injuries and illnesses and long-term disability insurance may not. Many states, however, permit dual recovery for asbestos-related conditions that develop years after the initial exposure. Talk to an experienced long-term individual disability attorney or award-winning group ERISA lawyer at DarrasLaw if you developed rheumatoid arthritis after asbestos or silica exposure.
- Obesity – Overweight individuals are at a greater risk of developing rheumatoid arthritis.
- Genetics – You have an increased risk of developing rheumatoid arthritis if a biological family member has it. You should always tell your treating physician about your family history.
- Gender – Women have a higher risk of developing rheumatoid arthritis than men.
You may have rheumatoid arthritis if you have one or more of the above risk factors in combination with the following initial symptoms:
- Pain and swelling in the joints on both sides of your body
- Increased symptoms in smaller joints first, such as fingers and toes
- Progressive symptoms in your wrists, ankles, knees, elbows, hips, and shoulders
- Warm and tender joints
- Joint stiffness that’s worse in the morning or after periods of inactivity
- Weight loss
You may experience a rheumatoid arthritis-related disability as soon as the pain and stiffness in your fingers prevents you from performing the important tasks of your occupation. This can even take place during early stage rheumatoid arthritis.
Conditions and Complications Associated With Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder, so treating this condition can prove tricky. It requires patients to take powerful steroids and inhibitors that suppress their immune systems. Treatments leave them more susceptible to other disabling diseases. The common cold can easily turn into a serious condition that requires a hospital stay, leading to disability. Your treating doctor may determine that a traditional work environment presents too many dangers to your health and the risk of infection is too great for you to continue working.
The following conditions often develop as the result of or concurrent with rheumatoid arthritis:
- Disproportional body composition: Even people with a normal body mass index may have a disproportionate amount of fat compared to people without rheumatoid arthritis. This often results from loss of muscle mass due to rheumatoid arthritis and can lead to other diseases and problems.
- Osteoporosis: This condition causes weak and brittle bones that easily fracture. Certain medications taken for rheumatoid arthritis can cause osteoporosis. However, osteoporosis can also occur after years of immune system attacks that continuously weaken your joints and bones.
- Sjogren’s syndrome: This autoimmune disorder is commonly associated with rheumatoid arthritis. It attacks the entire body and results in extensive eye and mouth dryness, extreme fatigue, neuropathies, cancerous lymphomas, chronic pain, and major organ failure. It’s associated with the following symptoms:
- Dry mouth
- Sore and cracked tongue
- Dry and burning throat
- Dental decay
- Joint pain
- Digestive problems
- Difficulty talking, chewing or swallowing
- Infections – Rheumatoid arthritis treatments suppress your immune system, so opportunistic infections may attack. Patients are especially susceptible to respiratory infections (especially fungal infections), sexually transmitted diseases, tuberculosis, immune system cancers (like lymphoma), and pneumonia.
- Rheumatoid nodules – These bumps of tissue form around pressure points in your joints and even in your lungs. They can range in size from a bean to a walnut. While they are firm and don’t normally hurt, they can cause extreme pain and discomfort if they form near a nerve, resulting in disability.
- Carpal tunnel syndrome – This disorder occurs when the nerves in your wrists are compressed, creating numbness and tingling in the hands and fingers. Carpal tunnel can occur without rheumatoid arthritis, but is often associated because the inflammation from rheumatoid arthritis can compress the nerves in your arms and wrists.
- Lung disease – Your immune system often attacks, inflames, and scars your lungs if you have rheumatoid arthritis. This leads to shortness of breath that can worsen with time.
- Heart disease – Acquired heart disease often occurs when the blood vessels leading to your heart, or arteries, become clogged. This decreases the blood flow to your heart and body. It can result in a heart attack, brain damage, and even death. Certain patients with rheumatoid arthritis may suffer from heart attacks when their immune systems attack the arteries and the actual membrane that encloses the heart. This can lead to a hardening of the arteries that causes blockages and serious heart conditions.
- Lymphoma – A category of cancers of your actual immune system, lymphoma forms in your lymph nodes and white blood cells. Hodgkin and non-Hodgkin lymphomas are the two main types of lymphoma. Immunosuppressants allow certain viruses, such as Epstein-Barr, to attack your body, which often leads to lymphoma. Hospitals will commonly test lymphoma patients for rheumatoid arthritis and HIV.
Rheumatoid arthritis is a degenerative condition. Accordingly, many patients with early stage rheumatoid arthritis may believe it’s simply age-related. The earlier you treat it, however, the more likely you’ll avoid late-stage symptoms such as lung scarring and bone degeneration.
Individual and Group Long-Term Disability Benefits and Rheumatoid Arthritis
Autoimmune disorders often manifest with flare-ups. This means your symptoms aren’t constant. Still, you need to consistently treat your rheumatoid arthritis, even if you aren’t constantly symptomatic. This can help prevent serious conditions such as heart and lung disease from developing.
You may be fine one day and bedridden the next. This creates problems when you attend an “independent medical examination (IME)” with your insurance company’s physicians—who may also lack the proper training or specialization to diagnose rheumatoid arthritis.
For example, what if you’re completely stiff in the mornings but don’t have an IME appointment until the afternoon? How can your treating physician or insurance company doctor accurately measure your disability? What if you’re not suffering from a flare-up during your orthopedic examination or the pain and swelling seems to move between joints?
Always be honest during your examinations. Tell your treating doctor and any insurance company doctors if a movement is extremely painful or if they failed to address nerve pain and swelling in certain areas. Our stellar disability lawyers and skilled ERISA attorneys know what the IME doctors are looking for and can suggest protections for you during the examination. Furthermore, DarrasLaw understands rheumatoid arthritis and can help you and your treating doctors present the proper medical and occupational evidence to your disability carrier.
You can claim individual or group long-term disability benefits for diseases such as rheumatoid arthritis if it prevents you from performing the material and substantial duties of your occupation. Whether you qualify for individual or group long-term disability benefits may depend on your occupation and the extent and severity of your restrictions and limitations. Joint stiffness is often especially prevalent in the mornings. What if you’re a bus driver and can’t report to work at 5 a.m., or a court reporter who can’t continuously type?
At DarrasLaw, America’s award-winning long-term individual disability lawyers and nationally respected group ERISA attorneys know how to fight bad-faith delays, denials, and terminations of individual or group long-term disability benefits. We can work with you and your treating doctors to advocate for your legal rights.
Call America’s Top-Rated Long-Term Disability Lawyers and Award-Winning Group ERISA Attorneys for a Free, Confidential Consultation
Arthritis is one of the most common disabling conditions in the United States, but it’s also among the most commonly misunderstood. Rheumatoid arthritis is a serious autoimmune disease and your individual or group ERISA long-term disability insurance company should pay these claims.
The nation’s top-rated long-term disability lawyer, Frank N. Darras, and his firms have recovered nearly $1 billion in wrongfully delayed, denied, and terminated insurance benefits. Call the compassionate long-term individual disability attorneys and nationally prominent group ERISA lawyers at DarrasLaw to schedule your free disability policy analysis and free claim consultation. If you experienced a bad-faith delay, denial, or termination of your individual or group long-term disability benefits, contact us at (800) 458-4577 or online today.
I Have Rheumatoid Arthritis – Am I Entitled To Disability Benefits? Qualifying Through A Listing
The Sullivan Law Office provides assistance in ensuring that all applicants and recipients receive all of the benefits to which they are entitled in all types of disability cases, regardless of the disability. Working with an experienced disability attorney ensures that a complete and accurate application is filed with the Social Security Administration (SSA) and that all relevant, supportive information, including medical evidence, is gathered in support of a prospective claimant’s application.
Rheumatoid arthritis, also known as RA, is an autoimmune disorder that results from the immune system attacking membranes surrounding their joints, causing inflammation. RA is most common in women, people between the ages of 40-60, smokers, and those with a family history of RA.
Symptoms of rheumatoid arthritis include pain beginning in the joints of the hands and feet, in time soon followed by the warming, stiffening, and swelling of the joints. RA may also permanently deform the joints. Fatigue, fevers, weight loss, as well as rheumatoid nodules, which are bumps of tissue, are other symptoms of RA.
There is no cure nor test that may diagnose RA. Its likelihood may be shown through some blood tests. Treatments include lifestyle remedies, therapy, medications, and even surgery in serious, extreme cases.
Social Security has listing for “inflammatory arthritis” in its Blue Book. Applicants must have significant limitations in their abilities, these include:
- significant difficulty walking (the need to use a cane, walker, or wheelchair);
- the inability to perform many types of tasks with arms that involve large muscle movements and small manipulations;
- inflammation or a permanent deformity in one or more major joints, along with moderate involvement of at least two more organs or body systems, causing at least two symptoms out of these four: severe fatigue, fever, malaise, and/or involuntary weight loss;
- ankylosing spondylitis or another spondyloarthropathy, with fixation of the spine of at least 45 degrees;
- ankylosing spondylitis or another spondyloarthropathy with fixation of the spine of at least 30 degrees, along with moderate involvement of at least two or more body systems; or
- repeated flare-ups of RA with at least two of symptoms that cause limitations in activities of daily living, social functioning, or the ability to finish and complete tasks.
Taking advantage of the legal services offered by the Sullivan Law Office may be seamless and involve as little friction as possible. The Sullivan Law Office provides assistance in ensuring that all applicants and recipients receive all of the benefits to which they are entitled in all types of disability cases. These include Social Security Disability, long-term disability, short-term disability, state retirement and workers’ compensation. Contact the Sullivan Law Office today. We offer free consultations, so you have absolutely nothing to lose! We look forward to hearing from you. Call 888-587-0228 or visit us online.
Social Security Disability Benefits for Arthritis
Arthritis occurs when there is inflammation of the joints. Fractures or breaks in the bone, obesity, age, autoimmune disorders, and bacterial or viral infections can all cause arthritis. Arthritis can cause significant pain, redness, and swelling of the joints and often limits one’s ability to perform everyday activities.
Can I Get Disability for My Arthritis?
To decide whether you should be approved for disability based on your arthritis, the Social Security Administration (SSA) goes through several steps. If you are working, the SSA will first determine whether you are working above the substantial gainful activity (SGA) level. For 2019, this amount was $1,220 or more a month. This means that if you earn $1,220 or more per month, the SSA will find that you are engaged in SGA, and your claim will be denied.
If the SSA determines you are not working at the SGA level, it will next determine whether your arthritis is expected to last at least 12 months and is a “severe” impairment. Under the SSA’s standards, a “severe” impairment is one that causes a significant impact on your ability to do work-related activities.
At the next step, the SSA must determine whether your arthritis meets (or “equals”) one of the conditions established in the SSA’s Listing of Impairments; if your arthritis meets the criteria under a condition in the Listing of Impairments, your claim for disability will be automatically approved. If it doesn’t, you may still be able to get disability benefits another way (see below).
Does My Arthritis Meet a Listing?
The SSA lays out the criteria needed for arthritis to be a qualifying medical condition under four separate listings in the SSA’s impairment listings: Listing 1. 02, Listing 1.03, Listing 1.04, and Listing 14.09.
Listing 1.02, Joint Dysfunction
If your arthritis has caused major dysfunction of any of your joints, you may be automatically eligible for disability under Listing 1.02. To qualify under Listing 1.02 you must prove that your arthritis has caused some type of deformity, such as excess boniness, misalignment, or permanent shortening of a joint, with chronic pain and stiffness that prevents you from using your joint fully. You must have x-rays or other images of the joint that show the joint space narrowing, bony destruction, or ankylosis (crookedness) of the joints. In addition, you have to have arthritis in either:
- the hip, knee, or ankle that causes significant difficulty walking, or
- the shoulder, elbow, or wrist/hand that prevents you from doing activities like holding a pen, typing or lifting.
If you suspect you would qualify under this listing, ask your doctor if your x-rays show a type of deformity mentioned above.
Listing 1.03, Surgery of a Weight-Bearing Joint
If you have undergone reconstructive surgery or surgical arthrodesis (fusion) of a major weight-bearing joint, such as a hip or knee, as a result of your arthritis and you can no longer walk on your own effectively (and are not expected to walk well on your own within a year), you could be approved automatically for disability under Listing 1.03.
Listing 1.04, Disorders of the Spine
If you suffer from arthritis of the spine (including osteoarthritis and facet arthritis), you may qualify for disability under Listing 1.04. In order to qualify for disability under Listing 1.04, you must show that you suffer from an arthritis-related disorder of the spine that compromises a nerve root or the spinal cord with one of the following complications:
Nerve root compression that causes wide-spread, nerve-related pain, limited flexibility, and weakened muscles, with a loss of reflex and sensation. If the lower back is involved, then you must have a positive straight-leg test.
Spinal arachnoiditis (inflammation of the protective membranes that surround the nerves of the spinal cord) that results in painful burning or other abnormal sensations and requires you to change positions more than once every two hours.
Lumbar spinal stenosis (narrowing of the spinal canal) that causes non-nerve related pain in the lower back, lower limbs, or buttocks, with weakness in the lower extremities that makes walking on your own difficult (that is, you need to use a walker or crutches or need assistance getting to work).
Because the listing criteria are complex, ask your doctor to determine whether your arthritis meets one of these listing requirements.
Listing 14.09, Inflammatory arthritis
If you don’t qualify for disability under any of the above listings, you may qualify under Listing 14.09, Inflammatory arthritis (this includes rheumatoid arthritis, psoriatic arthritis, and reactive arthritis). To meet Listing 14.09, you must provide objective medical evidence that your arthritis has resulted in the following:
- Swelling or deformity of:
- your hip, knee or ankle joints that causes extreme interference with your ability to walk on your own, or
- your shoulder, elbow or wrist/hand that makes it difficult to take care of yourself and perform your day-to-day activities.
- Swelling or deformity of your hip, knee, shoulder, elbow, wrist/hand, or ankle/footwith:
- associated disease in at least two of your organs or body systems, with one organ or body system affected more than minimally, and
- at least two of following: severe fatigue, malaise, weight loss, or fever.
- Ankylosing spondylitis(inflammatory disease that causes your bones to fuse together) with:
- Fixation of the lower or upper spine with extremely limited flexibility of 45